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Dental Disease Burden Snacking, and Tooth Brushing Habits and Among 13-17-Year-Olds with Fluorosis Compared to Those Without Dental Fluorosis in Kajiado Kenya

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Dental Disease Burden Snacking, and Tooth Brushing Habits and Among 13-17-Year-Olds with Fluorosis Compared to Those Without Dental Fluorosis in Kajiado Kenya Modern Approaches in Dentistry and L UPINE PUBLISHERS Oral Health Care Open Access DOI: 10.32474/MADOHC.2018.02.000134 ISSN: 2637-4692 Research Article Dental Disease Burden Snacking, and Tooth Brushing Habits and Among 13-17-Year-Olds with Fluorosis Compared to those without Dental Fluorosis in Kajiado Kenya Gladys N Opinya1* and Mavindu Mildred Ndoti2 1Professor of Paediatric Dentistry, Department of Paediatric Dentistry & Orthodontics, School of Dental Sciences, College of Health Sciences, University of Nairobi, Kenya 2Department of Paediatric Dentistry & Orthodontics, School of Dental Sciences, College of Health Sciences, University of Nairobi, Kenya Received: April 13, 2018; Published: May 08, 2018 *Corresponding author: Gladys Opinya, Department of Paediatric Dentistry & Orthodontics, School of Dental Sciences, College of Health Sciences, University of Nairobi Abstract understanding and therefore rationalise planning for oral health resources, utilization, and personnel distribution to tackle the The dental disease burden of periodontitis, gingivitis caries, and fluorosis has to be assessed objectively with patients’ disease burden. The study sought to assess the prevalence of dental fluorosis and the snacking and brushing habits to determine the dental disease burden, among 13-17- year- olds who were affected by dental fluorosis in comparison with those who were not affected with dental fluorosis in Kajiado North District of Kenya. The study cross-section and it compared dental disease burden among two age-matched population groups one with varying degrees of dental fluorosis and the second group without dental fluorosis teeth in primary school children aged between 13-15 years of age. Nine primary schools were randomly selected in Kajiado burden was determined through a clinical examination for each child under natural light. Plaque and gingival scores, dental caries North County which had been purposively selected. The instruments of examination were a questionnaire on child’s biodata. Disease the decayed, missing, filled teeth (DMFT) were, and dental fluorosis was assessed using the Thylstrup Fejerskov index (TFI). The study involved 248 children, who were matched for age and gender aged between 13-17 years with a mean age of 14.75±1.45 years. A total of 3472 teeth were examined, and prevalence of dental fluorosis in 3472 teeth of 124 children who were matched for age and gender with 124 without dental fluorosis was 3,375 (97.2 %) of the teeth surfaces. The prevalence dental fluorosis in 1680 maxillary teeth was (96.9%) while mandibular teeth surface it affected 1690 (97.5%) teeth. The differences were significant with a Chi-square test = 85.67 d.f=12, p= 0.001at 95%CL. The mean plaque score of 0.98±0.61 in children with dental fluorosis was lower compared with the mean plaque of 1.24±0.69 for children without fluorosis. The difference significant with a Pearson Chi square=72.540 d.f=12 p=0.002 at 95%CL. The children with fluorosis who brushed once after breakfast had the lowest plaque scores of 0.85±0.5 compared to those without dental fluorosis and the difference were statistically significant [one-way ANOVA F=- 2.97, p=0.003 at 95%CL. The gingival index for that ith fluorosis was 0.46±0.55 and individuals without fluorosis the gingival index was 0.48±0.53, and the difference was insignificant. However, the prevalence of gingivitis in girls was 139(93%) while the boys had a prevalence of 77(79%). The difference was statistically significant difference, Pearson Chi-square test=75.34, d.f=12, p=0.001 at affected by periodontitis. 95% CL. Periodontitis was found in 3(1.2%) participants of those with dental fluorosis none of those with dental fluorosis were The caries experience for the 248 children was at a low mean DMFT of 0.45±1.15. The individuals with dental fluorosis had a mean DMFT of 0.54±1.24 while those without dental fluorosis had a mean DMFT was 0.36±1.04, and the difference in the mean DMFT with a t-test was insignificant. In general children with dental fluorosis, who consumed sugary snacks had higher mean Citation: Gladys N O, Mavindu M N. Dental Disease Burden Snacking, and Tooth Brushing Habits and Among 13-17-Year-Olds with Fluorosis Compared to those without Dental Fluorosis in Kajiado Kenya. Mod App Dent Oral Health 2(2)- 2018. MADOHC.MS.ID.000134. DOI: 10.32474/ MADOHC.2018.02.000134. 144 Mod App Dent Oral Health Copyrights@ Gladys O, et al. DMFTs when compared with children without dental fluorosis who consumed sugary snacks. Although there was a higher disease burden in individuals with dental fluorosis when compared with those without dental fluorosis, the difference was insignificant with a paired t-test, where t=1.291, d.f=3, p=0.287 at 95%CL. In conclusion, the individuals who had varying severities of dental fluorosis withKeywords: frequent Fluorosed snacking hadTeeth; higher Disease DMFT. Burden; Also the Snacking; disease Adolescents burden was higher in children with dental fluorosis. Abbreviations: DMFT: Decayed Missing, Filled Teeth; TFI: Thylstrup Fejerskov index; WHO: World Health Organization; TFI: Thylstrup and Fejerskov index Introduction Chibole in Kenya, Cunha - Cruz. in the USA and Tagliaferro indicated The World Health Organization (WHO) statistics indicate that dental caries and periodontitis constitute the most critical global oral a direct relationship between the severity of dental fluorosis and dental caries [9-14]. A study on dental fluorosis, caries experience oral diseases vary in different parts of the world and within the same and snack intake of in 275 adolescents 13-15 year olds in Kenya health disease burden [1]. However, the distribution and severity of 88(52%) had TFI (Thylstrup and Fejerskov index) score 1-4 severity of dental fluorosis and a corresponding mean DMFT of country or region [2]. In the Kenyan situation, The 13-17 year olds like caries and periodontitis, and likewise, those not affected by 1.53 61.005. Furthermore, 82 (48.2%) of the 13-17 year olds had affected by fluorosis may have a combination of other oral diseases severe degrees of dental fluorosis of TFI scores 5-9 and a related needs of these two populations are often varied depending on the DMFT of 1.85±24 [13,14]. Wondwossen also, correlated enamel dental fluorosis may suffer from similar problems. The treatment severity of their conditions and assessments. Bacteria involved in fluorosis and dental caries in U.S schoolchildren and reported consistently had lower levels of caries experience than did healthy dental caries dimineralise he hard tooth structure including enamel, permanent maxillary right first molars which had dental fluorosis dentine, and cementum which progressively break down through molars [15]. Another study by Iida. showed that teeth with fluorosis were more resistant to caries [16]. A survey conducted in Namibia demineralization Rosenberg [2]. Many factors are associated with drinking water alone do not result in acceptable caries levels so that over a period in such a way as to encourage demineralization of the by Berndt et al. indicated that high concentrations of fluoride in dental caries where the diet, host and the microbial flora interact there are other factors involved in the causation of dental caries tooth enamel with resultant caries formation. Dental caries affects many children making it a public health concern and is likely to [17]. Dental fluorosis is more likely to occur in children exposed and 30 months of age. It was further noted by Rodrigues et al. that to levels of fluoride above the recommended 1ppm between 20 increase in cases of severe dental fluorosis due to enamel pitting usually sensitive discouraging plaque control measures through that encourages plaque retention. Affected teeth by fluorosis are between one and four years of age and that there is no risk after tooth brushing. Dental caries is counted among the common the critical period for the risk of dental fluorosis development is diseases in the world today. Evidence from WHO indicates that using several indices and the three principal ones in use today dental caries is less prevalent in the developed compared to the eight years of age [18]. The clinical appearance has been classified developing countries. The World Health Organization considers indices although a recent Fluorosis Risk Index, was developed by include the Dean’s. The Thylstrup and Fejerskov and Horowitz dental as a significant problem in oral health in the industrialized found to be appealing to clinicians and epidemiologists by Rozier dental caries is expected to increase in many developing countries Pendrys [13,19-22]. The Thylstrup and Fejerskov Index (TFI) was countries, affecting 60-90% of schoolchildren [3]. The incidence of since it corresponds closely to histopathological changes that occur in Africa, due to an increase in sugar intake [3]. A national oral to enamel due to dental fluorosis, thereby having biological validity health survey 2015 reported a DMFT of 0.42 in adolescents aged [23]. A study conducted in Tanzania by Roman showed that based 11=7 years while Ng’anga an. among 13-15-year-olds in Kenya had on this index varying degrees of fluorosis are scored with mild shown a mean DMFT of 1.8 [4,5]. Ng’ang’a showed that the under fluorosis being TF 1-3, moderate TF 4-5, and severe TF 6-9 [24]. 18 - year - olds had DMFT 0.2-1.8; the 12-15- year - olds had a DMFT The prevalence of dental fluorosis in permanent teeth in areas of 1.2-1.9 [6]. A study by Owino showed an overall prevalence of with fluoridated water had increased from 10-15% in the 1940s dental caries among 12-year-olds was 50.3% while its prevalence Disease Control/ National Centre for Health Statistics in the USA to as high as 70% in the USA by Marshal et al.
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